Re: Depression and weight loss

[Guest guest]

Hi,

Here is an interesting article on the use of 5HTP for depression, weight

loss, headaches and a host of other problems. Dr. Murray was one of Dr.

Leu's (my ND) instructors at Bastyr Naturopathic College. Dr. Murray also

has a newsletter on his website that you can subscribe to if you are

interested. His website is doctormurray.com. There is a lot of really

interesting information there!

Kenda

Answers to Common Questions on 5-Hydroxytryptophan

Introduction

5-Hydroxytryptophan (5-HTP) is an amino acid that is the intermediate step

between tryptophan and the important brain chemical serotonin. There is a

massive amount of evidence that suggests that low serotonin levels are a

common consequence of modern living. The lifestyle and dietary practices of

many people living in this stress-filled era results in lowered levels of

serotonin within the brain. As a result, many people are overweight, crave

sugar and other carbohydrates, experience bouts of depression, get frequent

headaches, and have vague muscle aches and pain. All of these maladies are

correctable by raising brain serotonin levels. The primary therapeutic

applications for 5-HTP is for low serotonin states such as:

* Depression

* Obesity

* Carbohydrate craving

* Bulimia

* Insomnia

* Narcolepsy

* Sleep apnea

* Migraine headaches

* Tension headaches

* Chronic daily headaches

* Premenstrual syndrome

* Fibromyalgia

Although 5-HTP is relatively new to the United States as a dietary

supplement, it has been available in several European countries as a

medicine since the 1970s.

What advantages does 5-HTP have over L-tryptophan?

There are many advantages of 5-HTP over L-tryptophan. First of all, because

it is one step closer to serotonin it is more effective. 5-HTP is also

inherently safer. Although L-tryptophan is safe if properly prepared and

free of the contaminants linked to a severe allergic reaction known as

eosinophilia myalgia syndrome (EMS), 5-HTP is a much better choice from a

therapeutic and safety perspective. Most commercially available 5-HTP is

isolated from a natural source ­ a seed from an African plant (Griffonia

simplicifolia).

Has 5-HTP been studied in the treatment of depression?

There is excellent documentation that 5-HTP is an effective antidepressant

agent. 5-HTP often produces very good results in patients who are

unresponsive to standard antidepressant drugs. One of the more impressive

studies involved 99 patients described as suffering from ³therapy resistant²

depression. 1 These patients had not responded to any previous therapy

including all available antidepressant drugs as well as electroconvulsive

therapy. These therapy resistant patients received 5-HTP at dosages

averaging 200 mg daily but ranging from 50 to 600 mg per day. Complete

recovery was seen in 43 of the 99 patients and significant improvement was

noted in 8 more. Such significant improvement in patients suffering from

long-standing, unresponsive depression is quite impressive prompting the

author of another study to state ³5-HTP merits a place in the front of the

ranks of the antidepressants instead of being used as a last resort. I have

never in 20 years used an agent which: (1) was effective so quickly; (2)

restored the patients so completely to the persons they had been and their

partners had known; [and] (3) was so entirely without side effects.² 2

Are there any studies where 5-HTP was compared directly to antidepressant

drugs?

Yes, there are several. 5-HTP is equal to or better than standard

antidepressant drugs and the side effects are much less severe. The study

with the most significance was one that compared to fluvoxamine, a

³selective serotonin reuptake inhibitor² like Prozac, Paxil, and Zoloft. In

the study, subjects received either 5-HTP (100 mg) or fluvoxamine (50 mg)

three times daily for 6 weeks. 3 The percentage decrease in overall

depression scores was slightly better in the 5-HTP group (60.7% vs. 56.1%).

More patients responded to 5-HTP than fluvoxamine and 5-HTP was quicker

acting than the fluvoxamine.

The real advantage of 5-HTP in this study was the low rate of side effect.

Here is how the physicians described the differences among the two groups:

³Whereas the two treatment groups did not differ significantly in the number

of patients sustaining adverse events, the interaction between the degree of

severity and the type of medication was highly significant: fluvoxamine

predominantly produced moderate to severe, oxitriptan [5-HTP] primarily mild

forms of adverse effects.²

The most common side effects with 5-HTP were nausea, heartburn, and

gastrointestinal problems (flatulence, feelings of fullness, and rumbling

sensations). These side effects were rated as being very mild to mild. In

contrast, most of the side effects experienced in the fluvoxamine group were

of moderate to severe intensity.

Using 5-HTP in enteric-coated capsules or tablets (pills prepared in a

manner so that they will not dissolve in the stomach) significantly reduces

the likelihood of nausea.

What effect does 5-HTP have on weight loss?

As far back as 1975, researchers demonstrated that administering 5-HTP) to

rats that were bred to overeat and be obese resulted in significant

reduction in food intake. 4 It turns out that these rats have decreased

activity of the enzyme that converts tryptophan to 5-HTP and subsequently to

serotonin. In other words, these rats are fat as a result of a genetically

determined low level of activity of the enzyme that starts the manufacture

of serotonin from tryptophan. As a result, these rats never get the message

to stop eating until they have consumed far greater amounts of food than

normal rats.

There is much circumstantial evidence that many humansare genetically

predisposed to obesity. This predisposition may involve the same mechanism

as that observed in rats genetically predisposed to obesity. In other words,

many people may be predisposed to being overweight because they have a

decreased conversion of tryptophan to 5-HTP and, as a result, decreased

serotonin levels. By providing preformed 5-HTP, this genetic defect is

bypassed and more serotonin is manufactured. 5-HTP literally turns off

hunger. 5

The early animal studies that used 5-HTP as a weight loss aid have been

followed by a series of four human clinical studies of overweight women,

conducted at the University of Rome. 6-9 The first study showed that 5-HTP

was able to reduce caloric intake and promote weight loss despite the fact

that the women made no conscious effort to lose weight. 8 The average amount

of weight loss during the five-week period of 5-HTP supplementation was a

little more than 3 pounds.

The second study sought to determine whether 5-HTP helped overweight

individuals adhere to dietary recommendations. 9 The twelve-week study was

divided into two six-week periods. For the first six weeks, there were no

dietary recommendations; for the second six weeks the women were placed on a

1,200-calorie diet. As shown in Table 1, the women who took the placebo lost

2.28 pounds, while the women who took the 5-HTP lost 10.34 pounds.

As in the previous study, 5-HTP appeared to promote weight loss by promoting

satiety‹the feeling of satisfaction‹leading to fewer calories being consumed

at meals. Every woman who took the 5-HTP reported early satiety.

In the third study involving 5-HTP, for the first six weeks there were no

dietary restrictions, and for the second six weeks the women were placed on

a 1,200-calorie-per-day diet. 10 The results from this study were even more

impressive than the previous studies for several reasons. The group that

received the 5-HTP had lost an average of 4.39 pounds at six weeks and an

average of 11.63 pounds at 12 weeks. In comparison, the placebo group had

lost an average of only 0.62 pounds at six weeks and 1.87 pounds at twelve

weeks. The lack of weight loss during the second six-week period in the

placebo group obviously reflects the fact that the women had difficulty

adhering to the diet.

Early satiety was reported by 100 percent of the subjects during the first

six-week period. During the second six-week period, even with severe caloric

restriction, ninety percent of the women taking 5-HTP reported early

satiety. Many of the women who received the 5-HTP (300 mg three times per

day) reported mild nausea during the first six weeks of therapy. However,

the symptom was never severe enough for any of the women to drop out of the

study. No other side effects were reported.

In the latest study, 25 overweight non-insulin dependent diabetic

outpatients were enrolled in a double-blind, placebo-controlled study, and

randomized to receive either 5-HTP (750 mg/d) or placebo for two consecutive

weeks, during which no dietary restriction was prescribed. 9 Results again

indicated that patients receiving 5-HTP significantly decreased their daily

energy intake, by reducing carbohydrate and fat intake, and reduced their

body weight.

While these studies used relatively high dosages, my feeling is that lower

dosages (e.g., 100 mg twenty minutes before meals) are just as effective

(especially from a cost perspective).

How does 5-HTP compare with melatonin in the treatment of insomnia?

5-HTP may prove to be better than melatonin. Several clinical studies have

shown 5-HTP to produce good results in promoting and maintaining sleep in

normal subjects as well as those experiencing insomnia. 10-13One of the key

benefits with 5-HTP in the treatment of insomnia, is its ability to increase

sleep quality.

How does 5-HTP benefit headache sufferers?

Because chronic headache sufferers have low levels of serotonin in their

tissues, some researchers refer to migraine and chronic headaches as a ³low

serotonin syndrome.² 14 There have been several clinical studies with 5-HTP

in headaches, both migraine and tension headaches, that have showed

excellent results. 14-20 In particular, the use of 5-HTP in the prevention

of migraine headache offers considerable advantages over drug therapy.

Although a number of drugs have been shown to be useful in the prevention of

migraine headaches, all of them carry significant side effects. In contrast,

5-HTP is very safe.

What is fibromyalgia and how does 5-HTP help?

Fibromyalgia is a recently recognized disorder regarded as a common cause of

chronic musculoskeletal pain and fatigue. The history of the development of

5-HTP as an effective treatment for fibromyalgia began with studies on the

drug fenclonine. 21 This drug blocks the enzyme which converts tryptophan to

5-HTP and as result blocks serotonin production. During the late 1960s and

early 1970s, it was thought that increased serotonin formation may promote

migraine headaches (the opposite of what was later proved, i.e., increasing

serotonin levels reduce migraine headache occurrence). The researchers

discovered that providing headache sufferers with fenclonine resulted in

very severe muscle pain. This effect was exactly opposite of what was

expected, but led to some important advances in the understanding of

fibromyalgia--a way to induce its severe symptoms of (as well as symptoms

nearly identical to EMS, the condition caused by contaminated L-tryptophan).

The researchers also discovered that migraine sufferers reacted to the drug

much more than non-headache sufferers. In fact, in most normal subjects

fenclonine produced no fibromyalgia. These occurrences highlight just how

sensitive migraine sufferers are to low serotonin levels.

Migraine headaches and fibromyalgia share a common feature: both are low

serotonin syndromes. After over 25 years of research, one of the lead

researchers has stated that ³In our experience, as well as in that of other

pain specialists, 5-HTP can largely improve the painful picture of primary

fibromyalgia.² 22 Double-blind studies support this contention. 23,24

What is the best way to take 5-HTP?

For depression, weight loss, headaches, and fibromyalgia the dosage should

be started at 50 mg three times per day. If the response is inadequate after

two weeks, increase the dosage to 100 mg three times per day. This

recommendation will greatly reduce the mild symptoms of nausea often

experienced during the first few weeks of 5-HTP therapy. Using

enteric-coated capsules or tablets (pills prepared in a manner so that they

will not dissolve in the stomach) significantly reduces the likelihood of

nausea. Because 5-HTP does not rely on the same transport vehicle as

L-tryptophan, it can also be taken with food. But, if you are taking for

weight loss I recommend taking it 20 minutes before meals.

For insomnia, I recommend 100 to 300 mg thirty to forty-five minutes before

retiring. Start with the lower dose for at least three days before

increasing dosage.

Can 5-HTP be taken with St. ¹s wort extract?

Yes. In fact, the two seem to work very well together. St. ¹s wort

extract has been shown in over 25 double-blind studies to be as or more

effective than antidepressant drugs in the treatment of mild to moderate

depression. In more severe cases, I recommend using 5-HTP along with St.

¹s wort. Be sure to use the St. ¹s wort extract standardized for

0.3% hypericin. The dosage for this extract is typically 300 mg three times

per day. When using it in combination with 5-HTP I recommend 50-100 mg of

5-HTP and 150-300 mg of St. ¹s wort extract three times daily.

What about using 5-HTP with antidepressant drugs?

Although 5-HTP has been shown to work very well with antidepressant drugs in

clinical trials, my recommendation is that if you are taking a prescription

antidepressant drug, DO NOT take 5-HTP until you consult with your doctor.

It is possible for serotonin levels to get too high. The result is a

condition known as the ³serotonin syndrome,² which is characterized by

confusion, fever, shivering, sweating, diarrhea, and muscle spasms.

That being said, with your doctor¹s supervision, 5-HTP can be used in

conjunction with antidepressant drugs. The typical dosage schedule is to

begin with a dosage of 5-HTP at 50 mg three times daily; after one month,

the dosage of the antidepressant drug can be cut in half. If satisfactory

response is achieved after the next month, increase the dosage of 5-HTP to

100 mg three times daily and discontinue the medication. Again, your

physician must supervise any change in the dosage of your medication.

Wasn¹t the drug Redux, which raises serotonin levels, taken off the market

because it caused damage to the heart valves due to elevated blood serotonin

levels? Is there a risk with 5-HTP doing the same?

In September 1997, the popular weight loss drug Redux and its chemical

cousin fenfluramine, part of the ³fen-phen² combination, were taken off the

market based on a study showing that these drugs may have caused permanent

damage to heart valves in as many as one-third of the people who took them.

There is no evidence that 5-HTP produces these effects. Unlike Redux, 5-HTP

does not raise blood serotonin levels to a significant degree nor does it

block reuptake of serotonin. The point here is that 5-HTP does not disrupt

the normal process of serotonin release, reabsorbtion, and elimination from

the body. 5-HTP is not a synthetic drug; it is an amino acid produced

naturally by your body¹s metabolism.

What is ³peak X?²

In 1998 researchers at the Mayo Clinic identified trace levels of a compound

they termed ³peak X² as a possible contaminant in 5-HTP products. 25 Though

the significance of this compound was never really established,

manufacturers of 5-HTP now screen for the presence of this compound to

insure that all of the 5-HTP on the marketplace is free from peak X as

outlined in current FDA methodology. There have been no reports of a single

person developing eosinophilia-myalgia syndrome (EMS) from 5-HTP despite its

popularity. Evidence that uncontaminated 5-HTP does not cause EMS is also

provided by researchers who have been using 5-HTP for over 30 years as well

as by researchers at the NIH studying the effects of uncontaminated 5-HTP on

various metabolic conditions.

Is 5-HTP safe for long term use?

Yes, but to be on the safe side I recommend that long-term continual use of

5-HTP be monitored by regular (every six months) eosinophil determination.

This determination is part of a standard laboratory blood test known as a

complete blood count (CBC).

* Do not use 5-HTP during pregnancy or lactation.

* Do not use 5-HTP in Parkinson¹s disease unless the drug Sinemet®.

* Do not use 5-HTP if you have sceleroderma (linked to a defect in

tryptophan metabolism).

Are there any drug interactions?

Again, because 5-HTP is the direct precursor to serotonin, it should not be

used by individuals taking antidepressant drugs without close medical

supervision. 5-HTP may antagonize the effects of drugs used in migraine

headaches like methysergide and cyproheptadine.

What about carbidopa and vitamin B6?

The drug carbidopa blocks the conversion of 5-HTP to serotonin from

occurring outside the brain. This effect initially was thought to be

desirable and the combination of 5-HTP and carbidopa was used in several

studies. However, studies using 5-HTP alone (i.e., without carbidopa) were

shown to produce even better results, especially in relieving depression.

Vitamin B6 is required for the conversion of 5-HTP to serotonin. Some

³experts² advise against taking 5-HTP at the same time with vitamin B6 while

others recommend taking the two simultaneously. The bottom line is that

there is no evidence that taking vitamin B6 with 5-HTP increases the

conversion of 5-HTP to serotonin in the blood (an undesirable effect) while

there is evidence that lack of vitamin B6 will definitely reduce brain

serotonin manufacture. My recommendation is that adequate B6 stores are

achieved by taking a high potency multiple vitamin and mineral formula.

Why does 5-HTP supplementation produce nausea?

Again, while nausea is a common side effect of 5-HTP, it can be avoided by

simply taking an enteric-coated product. 5-HTP induces nausea via a local

effect on the stomach lining.

Where can I get more information on 5-HTP?

The overwhelming majority of questions sent to me via my website are related

to 5-HTP. I have tried to answer all of the most common questions here. For

more information, see my book, 5-HTP ­ The Natural Way to Overcome

Depression, Obesity, and Insomnia (Bantam, 1998). It provides more detailed

information on 5-HTP and is available in book stores and health food stores

nationwide.

References

1. van Hiele JJ: L-5-hydroxytryptophan in depression: The first substitution

therapy in psychiatry? Neuropsychobiology 6:230-40, 1980

2. Kielholz P: Treatment for therapy-resistant depression. Psychopathology

19(Suppl. 2):194-200, 1986

3. Poldinger W, Calanchini B and Schwarz W: A functional-dimensional

approach to depression: Serotonin deficiency as a target syndrome in a

comparison of 5-hydroxytryptophan and fluvoxamine. Psychopathology 24:53-81,

1991

4. Wurtman RJ and Wurtman JJ: Brain serotonin, carbohydrate-craving, obesity

and depression. Adv Exp Med Biol 398:35-41, 1996

5. Blundel JE and Leshem MB: The effect of 5-HTP on food intake and on the

anorexic action of amphetamine and fenfluramine. J Pharm Pharmacol 27:31-7,

1975

6. Ceci F, et al.: The effects of oral 5-hydroxytryptophan administration on

feeding behavior in obese adult female subjects. J Neural Transm 76:109-17,

1989

7. Cangiano C, et al.: Effects of 5-hydroxytryptophan on eating behavior and

adherence to dietary prescriptions in obese adult subjects. Adv Exp Med Biol

294:591-3, 1991

8. Cangiano C, et al.: Eating behavior and adherence to dietary

prescriptions in obese adult subjects treated with 5-hydroxytryptophan. Am J

Clin Nutr 56:863-7, 1992

9. Cangiano C, Laviano A, Del Ben M, et al. Effects of oral

5-hydroxy-tryptophan on energy intake and macronutrient selection in

non-insulin dependent diabetic patients. Int J Obes Relat Metab Disord

22(7):648-54, 1998.

10. Wyatt RJ: The serotonin-catecholamine-dream bicycle: a clinical study.

Biol Psychiatry 5:33-64, 1972

11. Guilleminault C, Cathala HP and Castaigne P: Effects of 5-HTP on sleep

of a patient with brain stem lesion. Electroencephalog Clin Neurophysiol

34:177-84, 1973

12. Wyatt RJ, et al.: Effects of 5-hydroxytryptophan on the sleep of normal

human subjects. Electroencephalogr Clin Neurophysiol 30:505-9, 1971

13. Autret A, et al.: Human sleep and 5-HTP. Effects of repeated high doses

and of association with benserazide. Electroencephalogr Clin Neurophysiol

41:408-13, 1976

14. Soulairac A and Lambinet H: Clinical studies of the effect of the

serotonin precursor, L-5-hydroxytryptophan, on sleep disorders. Schweiz

Rundsch Med Prax 77:19-23, 1988

15. Titus F, et al.: 5-Hydroxytryptophan versus methysergide in the

prophylaxis of migraine. Randomized clinical trial. Eur Neurol 25:327-9,

1986

16. Bono G, et al.: Serotonin precursors in migraine prophylaxis. Adv Neurol

33:357-63, 1982

17. Maissen CP and Ludin HP: Comparison of the effect of 5-hydroxytryptophan

and propranolol in the interval treatment of migraine. Med Wochenschr

121:1585-90, 1991

18. De Giorgis G, et al.: Headache in association with sleep disorders in

children: a psychodiagnostic evaluation and controlled clinical

study--L-5-HTP versus placebo. Drugs Exp Clin Res 13:425-33, 1987

19. Santucci M, et al.: L-5-hydroxytryptophan versus placebo in childhood

migraine prophylaxis: A double-blind crossover study. Cephalgia 6:155-7,

1986

20. Ribeiro CA. L-5-Hydroxytryptophan in the prophylaxis of chronic

tension-type headache: a double-blind, randomized, placebo-controlled study.

For the Portuguese Head Society. Headache 2000;40:451-6.

21. Nicolodi M and Sicuteri F: Fibromyalgia and migraine, two faces of the

same mechanism. Serotonin as the common clue for pathogenesis and therapy.

Adv Exp Med Biol 398:373-9, 1996

22. Nicolodi M and Sicuteri F: Eosinophilia myalgia syndrome. The role of

contaminants, the role of serotonergic set up. Exp Biol Med 398:351-7, 1996

23. Caruso I, et al.: Double-blind study of 5-hydroxytryptophan versus

placebo in the treatment of primary fibromyalgia syndrome. J Int Med Res

18:201-9, 1990

24. Puttini PS and Caruso I: Primary fibromyalgia syndrome and

5-hydroxy-L-tryptophan: a 90-day open study. J Int Med Res 20:182-9, 1992

25. Klarskov K, et al. Eosinophilia-myalgia syndrome case-associated

contaminants in commercially available 5-hydroxytryptophan. Adv Exp Med Biol

467:461-8, 1999

 

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[Guest guest]

I wonder about combining this with SSRI antidepressants....

I am going to ask my doc

>

> Hi,

>

> Here is an interesting article on the use of 5HTP for depression, weight

> loss, headaches and a host of other problems. Dr. Murray was one of Dr.

> Leu's (my ND) instructors at Bastyr Naturopathic College. Dr. Murray also

> has a newsletter on his website that you can subscribe to if you are

> interested. His website is doctormurray.com. There is a lot of really

> interesting information there!

>

> Kenda

>

> Answers to Common Questions on 5-Hydroxytryptophan

>

> Introduction

>

> 5-Hydroxytryptophan (5-HTP) is an amino acid that is the intermediate step

> between tryptophan and the important brain chemical serotonin. There is a

> massive amount of evidence that suggests that low serotonin levels are a

> common consequence of modern living. The lifestyle and dietary practices of

> many people living in this stress-filled era results in lowered levels of

> serotonin within the brain. As a result, many people are overweight, crave

> sugar and other carbohydrates, experience bouts of depression, get frequent

> headaches, and have vague muscle aches and pain. All of these maladies are

> correctable by raising brain serotonin levels. The primary therapeutic

> applications for 5-HTP is for low serotonin states such as:

>

> * Depression

> * Obesity

> * Carbohydrate craving

> * Bulimia

> * Insomnia

> * Narcolepsy

> * Sleep apnea

> * Migraine headaches

> * Tension headaches

> * Chronic daily headaches

> * Premenstrual syndrome

> * Fibromyalgia

>

>

> Although 5-HTP is relatively new to the United States as a dietary

> supplement, it has been available in several European countries as a

> medicine since the 1970s.

>

> What advantages does 5-HTP have over L-tryptophan?

>

> There are many advantages of 5-HTP over L-tryptophan. First of all, because

> it is one step closer to serotonin it is more effective. 5-HTP is also

> inherently safer. Although L-tryptophan is safe if properly prepared and

> free of the contaminants linked to a severe allergic reaction known as

> eosinophilia myalgia syndrome (EMS), 5-HTP is a much better choice from a

> therapeutic and safety perspective. Most commercially available 5-HTP is

> isolated from a natural source ­ a seed from an African plant (Griffonia

> simplicifolia).

>

> Has 5-HTP been studied in the treatment of depression?

>

> There is excellent documentation that 5-HTP is an effective antidepressant

> agent. 5-HTP often produces very good results in patients who are

> unresponsive to standard antidepressant drugs. One of the more impressive

> studies involved 99 patients described as suffering from ³therapy resistant²

> depression. 1 These patients had not responded to any previous therapy

> including all available antidepressant drugs as well as electroconvulsive

> therapy. These therapy resistant patients received 5-HTP at dosages

> averaging 200 mg daily but ranging from 50 to 600 mg per day. Complete

> recovery was seen in 43 of the 99 patients and significant improvement was

> noted in 8 more. Such significant improvement in patients suffering from

> long-standing, unresponsive depression is quite impressive prompting the

> author of another study to state ³5-HTP merits a place in the front of the

> ranks of the antidepressants instead of being used as a last resort. I have

> never in 20 years used an agent which: (1) was effective so quickly; (2)

> restored the patients so completely to the persons they had been and their

> partners had known; [and] (3) was so entirely without side effects.² 2

>

> Are there any studies where 5-HTP was compared directly to antidepressant

> drugs?

>

> Yes, there are several. 5-HTP is equal to or better than standard

> antidepressant drugs and the side effects are much less severe. The study

> with the most significance was one that compared to fluvoxamine, a

> ³selective serotonin reuptake inhibitor² like Prozac, Paxil, and Zoloft. In

> the study, subjects received either 5-HTP (100 mg) or fluvoxamine (50 mg)

> three times daily for 6 weeks. 3 The percentage decrease in overall

> depression scores was slightly better in the 5-HTP group (60.7% vs. 56.1%).

> More patients responded to 5-HTP than fluvoxamine and 5-HTP was quicker

> acting than the fluvoxamine.

>

> The real advantage of 5-HTP in this study was the low rate of side effect.

> Here is how the physicians described the differences among the two groups:

>

> ³Whereas the two treatment groups did not differ significantly in the number

> of patients sustaining adverse events, the interaction between the degree of

> severity and the type of medication was highly significant: fluvoxamine

> predominantly produced moderate to severe, oxitriptan [5-HTP] primarily mild

> forms of adverse effects.²

>

> The most common side effects with 5-HTP were nausea, heartburn, and

> gastrointestinal problems (flatulence, feelings of fullness, and rumbling

> sensations). These side effects were rated as being very mild to mild. In

> contrast, most of the side effects experienced in the fluvoxamine group were

> of moderate to severe intensity.

>

> Using 5-HTP in enteric-coated capsules or tablets (pills prepared in a

> manner so that they will not dissolve in the stomach) significantly reduces

> the likelihood of nausea.

>

> What effect does 5-HTP have on weight loss?

>

> As far back as 1975, researchers demonstrated that administering 5-HTP) to

> rats that were bred to overeat and be obese resulted in significant

> reduction in food intake. 4 It turns out that these rats have decreased

> activity of the enzyme that converts tryptophan to 5-HTP and subsequently to

> serotonin. In other words, these rats are fat as a result of a genetically

> determined low level of activity of the enzyme that starts the manufacture

> of serotonin from tryptophan. As a result, these rats never get the message

> to stop eating until they have consumed far greater amounts of food than

> normal rats.

>

> There is much circumstantial evidence that many humansare genetically

> predisposed to obesity. This predisposition may involve the same mechanism

> as that observed in rats genetically predisposed to obesity. In other words,

> many people may be predisposed to being overweight because they have a

> decreased conversion of tryptophan to 5-HTP and, as a result, decreased

> serotonin levels. By providing preformed 5-HTP, this genetic defect is

> bypassed and more serotonin is manufactured. 5-HTP literally turns off

> hunger. 5

>

> The early animal studies that used 5-HTP as a weight loss aid have been

> followed by a series of four human clinical studies of overweight women,

> conducted at the University of Rome. 6-9 The first study showed that 5-HTP

> was able to reduce caloric intake and promote weight loss despite the fact

> that the women made no conscious effort to lose weight. 8 The average amount

> of weight loss during the five-week period of 5-HTP supplementation was a

> little more than 3 pounds.

>

> The second study sought to determine whether 5-HTP helped overweight

> individuals adhere to dietary recommendations. 9 The twelve-week study was

> divided into two six-week periods. For the first six weeks, there were no

> dietary recommendations; for the second six weeks the women were placed on a

> 1,200-calorie diet. As shown in Table 1, the women who took the placebo lost

> 2.28 pounds, while the women who took the 5-HTP lost 10.34 pounds.

>

> As in the previous study, 5-HTP appeared to promote weight loss by promoting

> satiety‹the feeling of satisfaction‹leading to fewer calories being consumed

> at meals. Every woman who took the 5-HTP reported early satiety.

>

> In the third study involving 5-HTP, for the first six weeks there were no

> dietary restrictions, and for the second six weeks the women were placed on

> a 1,200-calorie-per-day diet. 10 The results from this study were even more

> impressive than the previous studies for several reasons. The group that

> received the 5-HTP had lost an average of 4.39 pounds at six weeks and an

> average of 11.63 pounds at 12 weeks. In comparison, the placebo group had

> lost an average of only 0.62 pounds at six weeks and 1.87 pounds at twelve

> weeks. The lack of weight loss during the second six-week period in the

> placebo group obviously reflects the fact that the women had difficulty

> adhering to the diet.

>

> Early satiety was reported by 100 percent of the subjects during the first

> six-week period. During the second six-week period, even with severe caloric

> restriction, ninety percent of the women taking 5-HTP reported early

> satiety. Many of the women who received the 5-HTP (300 mg three times per

> day) reported mild nausea during the first six weeks of therapy. However,

> the symptom was never severe enough for any of the women to drop out of the

> study. No other side effects were reported.

>

> In the latest study, 25 overweight non-insulin dependent diabetic

> outpatients were enrolled in a double-blind, placebo-controlled study, and

> randomized to receive either 5-HTP (750 mg/d) or placebo for two consecutive

> weeks, during which no dietary restriction was prescribed. 9 Results again

> indicated that patients receiving 5-HTP significantly decreased their daily

> energy intake, by reducing carbohydrate and fat intake, and reduced their

> body weight.

>

> While these studies used relatively high dosages, my feeling is that lower

> dosages (e.g., 100 mg twenty minutes before meals) are just as effective

> (especially from a cost perspective).

>

> How does 5-HTP compare with melatonin in the treatment of insomnia?

>

> 5-HTP may prove to be better than melatonin. Several clinical studies have

> shown 5-HTP to produce good results in promoting and maintaining sleep in

> normal subjects as well as those experiencing insomnia. 10-13One of the key

> benefits with 5-HTP in the treatment of insomnia, is its ability to increase

> sleep quality.

>

> How does 5-HTP benefit headache sufferers?

>

> Because chronic headache sufferers have low levels of serotonin in their

> tissues, some researchers refer to migraine and chronic headaches as a ³low

> serotonin syndrome.² 14 There have been several clinical studies with 5-HTP

> in headaches, both migraine and tension headaches, that have showed

> excellent results. 14-20 In particular, the use of 5-HTP in the prevention

> of migraine headache offers considerable advantages over drug therapy.

> Although a number of drugs have been shown to be useful in the prevention of

> migraine headaches, all of them carry significant side effects. In contrast,

> 5-HTP is very safe.

>

> What is fibromyalgia and how does 5-HTP help?

>

> Fibromyalgia is a recently recognized disorder regarded as a common cause of

> chronic musculoskeletal pain and fatigue. The history of the development of

> 5-HTP as an effective treatment for fibromyalgia began with studies on the

> drug fenclonine. 21 This drug blocks the enzyme which converts tryptophan to

> 5-HTP and as result blocks serotonin production. During the late 1960s and

> early 1970s, it was thought that increased serotonin formation may promote

> migraine headaches (the opposite of what was later proved, i.e., increasing

> serotonin levels reduce migraine headache occurrence). The researchers

> discovered that providing headache sufferers with fenclonine resulted in

> very severe muscle pain. This effect was exactly opposite of what was

> expected, but led to some important advances in the understanding of

> fibromyalgia--a way to induce its severe symptoms of (as well as symptoms

> nearly identical to EMS, the condition caused by contaminated L-tryptophan).

> The researchers also discovered that migraine sufferers reacted to the drug

> much more than non-headache sufferers. In fact, in most normal subjects

> fenclonine produced no fibromyalgia. These occurrences highlight just how

> sensitive migraine sufferers are to low serotonin levels.

>

> Migraine headaches and fibromyalgia share a common feature: both are low

> serotonin syndromes. After over 25 years of research, one of the lead

> researchers has stated that ³In our experience, as well as in that of other

> pain specialists, 5-HTP can largely improve the painful picture of primary

> fibromyalgia.² 22 Double-blind studies support this contention. 23,24

>

> What is the best way to take 5-HTP?

>

> For depression, weight loss, headaches, and fibromyalgia the dosage should

> be started at 50 mg three times per day. If the response is inadequate after

> two weeks, increase the dosage to 100 mg three times per day. This

> recommendation will greatly reduce the mild symptoms of nausea often

> experienced during the first few weeks of 5-HTP therapy. Using

> enteric-coated capsules or tablets (pills prepared in a manner so that they

> will not dissolve in the stomach) significantly reduces the likelihood of

> nausea. Because 5-HTP does not rely on the same transport vehicle as

> L-tryptophan, it can also be taken with food. But, if you are taking for

> weight loss I recommend taking it 20 minutes before meals.

>

> For insomnia, I recommend 100 to 300 mg thirty to forty-five minutes before

> retiring. Start with the lower dose for at least three days before

> increasing dosage.

>

> Can 5-HTP be taken with St. ¹s wort extract?

>

> Yes. In fact, the two seem to work very well together. St. ¹s wort

> extract has been shown in over 25 double-blind studies to be as or more

> effective than antidepressant drugs in the treatment of mild to moderate

> depression. In more severe cases, I recommend using 5-HTP along with St.

> ¹s wort. Be sure to use the St. ¹s wort extract standardized for

> 0.3% hypericin. The dosage for this extract is typically 300 mg three times

> per day. When using it in combination with 5-HTP I recommend 50-100 mg of

> 5-HTP and 150-300 mg of St. ¹s wort extract three times daily.

>

> What about using 5-HTP with antidepressant drugs?

>

> Although 5-HTP has been shown to work very well with antidepressant drugs in

> clinical trials, my recommendation is that if you are taking a prescription

> antidepressant drug, DO NOT take 5-HTP until you consult with your doctor.

> It is possible for serotonin levels to get too high. The result is a

> condition known as the ³serotonin syndrome,² which is characterized by

> confusion, fever, shivering, sweating, diarrhea, and muscle spasms.

>

> That being said, with your doctor¹s supervision, 5-HTP can be used in

> conjunction with antidepressant drugs. The typical dosage schedule is to

> begin with a dosage of 5-HTP at 50 mg three times daily; after one month,

> the dosage of the antidepressant drug can be cut in half. If satisfactory

> response is achieved after the next month, increase the dosage of 5-HTP to

> 100 mg three times daily and discontinue the medication. Again, your

> physician must supervise any change in the dosage of your medication.

>

> Wasn¹t the drug Redux, which raises serotonin levels, taken off the market

> because it caused damage to the heart valves due to elevated blood serotonin

> levels? Is there a risk with 5-HTP doing the same?

>

> In September 1997, the popular weight loss drug Redux and its chemical

> cousin fenfluramine, part of the ³fen-phen² combination, were taken off the

> market based on a study showing that these drugs may have caused permanent

> damage to heart valves in as many as one-third of the people who took them.

> There is no evidence that 5-HTP produces these effects. Unlike Redux, 5-HTP

> does not raise blood serotonin levels to a significant degree nor does it

> block reuptake of serotonin. The point here is that 5-HTP does not disrupt

> the normal process of serotonin release, reabsorbtion, and elimination from

> the body. 5-HTP is not a synthetic drug; it is an amino acid produced

> naturally by your body¹s metabolism.

>

> What is ³peak X?²

>

> In 1998 researchers at the Mayo Clinic identified trace levels of a compound

> they termed ³peak X² as a possible contaminant in 5-HTP products. 25 Though

> the significance of this compound was never really established,

> manufacturers of 5-HTP now screen for the presence of this compound to

> insure that all of the 5-HTP on the marketplace is free from peak X as

> outlined in current FDA methodology. There have been no reports of a single

> person developing eosinophilia-myalgia syndrome (EMS) from 5-HTP despite its

> popularity. Evidence that uncontaminated 5-HTP does not cause EMS is also

> provided by researchers who have been using 5-HTP for over 30 years as well

> as by researchers at the NIH studying the effects of uncontaminated 5-HTP on

> various metabolic conditions.

>

> Is 5-HTP safe for long term use?

>

> Yes, but to be on the safe side I recommend that long-term continual use of

> 5-HTP be monitored by regular (every six months) eosinophil determination.

> This determination is part of a standard laboratory blood test known as a

> complete blood count (CBC).

>

> * Do not use 5-HTP during pregnancy or lactation.

> * Do not use 5-HTP in Parkinson¹s disease unless the drug Sinemet®.

> * Do not use 5-HTP if you have sceleroderma (linked to a defect in

> tryptophan metabolism).

>

>

> Are there any drug interactions?

>

> Again, because 5-HTP is the direct precursor to serotonin, it should not be

> used by individuals taking antidepressant drugs without close medical

> supervision. 5-HTP may antagonize the effects of drugs used in migraine

> headaches like methysergide and cyproheptadine.

>

> What about carbidopa and vitamin B6?

>

> The drug carbidopa blocks the conversion of 5-HTP to serotonin from

> occurring outside the brain. This effect initially was thought to be

> desirable and the combination of 5-HTP and carbidopa was used in several

> studies. However, studies using 5-HTP alone (i.e., without carbidopa) were

> shown to produce even better results, especially in relieving depression.

>

> Vitamin B6 is required for the conversion of 5-HTP to serotonin. Some

> ³experts² advise against taking 5-HTP at the same time with vitamin B6 while

> others recommend taking the two simultaneously. The bottom line is that

> there is no evidence that taking vitamin B6 with 5-HTP increases the

> conversion of 5-HTP to serotonin in the blood (an undesirable effect) while

> there is evidence that lack of vitamin B6 will definitely reduce brain

> serotonin manufacture. My recommendation is that adequate B6 stores are

> achieved by taking a high potency multiple vitamin and mineral formula.

>

> Why does 5-HTP supplementation produce nausea?

>

> Again, while nausea is a common side effect of 5-HTP, it can be avoided by

> simply taking an enteric-coated product. 5-HTP induces nausea via a local

> effect on the stomach lining.

>

> Where can I get more information on 5-HTP?

>

> The overwhelming majority of questions sent to me via my website are related

> to 5-HTP. I have tried to answer all of the most common questions here. For

> more information, see my book, 5-HTP ­ The Natural Way to Overcome

> Depression, Obesity, and Insomnia (Bantam, 1998). It provides more detailed

> information on 5-HTP and is available in book stores and health food stores

> nationwide.

>

> References

>

> 1. van Hiele JJ: L-5-hydroxytryptophan in depression: The first substitution

> therapy in psychiatry? Neuropsychobiology 6:230-40, 1980

>

> 2. Kielholz P: Treatment for therapy-resistant depression. Psychopathology

> 19(Suppl. 2):194-200, 1986

>

> 3. Poldinger W, Calanchini B and Schwarz W: A functional-dimensional

> approach to depression: Serotonin deficiency as a target syndrome in a

> comparison of 5-hydroxytryptophan and fluvoxamine. Psychopathology 24:53-81,

> 1991

>

> 4. Wurtman RJ and Wurtman JJ: Brain serotonin, carbohydrate-craving, obesity

> and depression. Adv Exp Med Biol 398:35-41, 1996

>

> 5. Blundel JE and Leshem MB: The effect of 5-HTP on food intake and on the

> anorexic action of amphetamine and fenfluramine. J Pharm Pharmacol 27:31-7,

> 1975

>

> 6. Ceci F, et al.: The effects of oral 5-hydroxytryptophan administration on

> feeding behavior in obese adult female subjects. J Neural Transm 76:109-17,

> 1989

>

> 7. Cangiano C, et al.: Effects of 5-hydroxytryptophan on eating behavior and

> adherence to dietary prescriptions in obese adult subjects. Adv Exp Med Biol

> 294:591-3, 1991

>

> 8. Cangiano C, et al.: Eating behavior and adherence to dietary

> prescriptions in obese adult subjects treated with 5-hydroxytryptophan. Am J

> Clin Nutr 56:863-7, 1992

>

> 9. Cangiano C, Laviano A, Del Ben M, et al. Effects of oral

> 5-hydroxy-tryptophan on energy intake and macronutrient selection in

> non-insulin dependent diabetic patients. Int J Obes Relat Metab Disord

> 22(7):648-54, 1998.

>

> 10. Wyatt RJ: The serotonin-catecholamine-dream bicycle: a clinical study.

> Biol Psychiatry 5:33-64, 1972

>

> 11. Guilleminault C, Cathala HP and Castaigne P: Effects of 5-HTP on sleep

> of a patient with brain stem lesion. Electroencephalog Clin Neurophysiol

> 34:177-84, 1973

>

> 12. Wyatt RJ, et al.: Effects of 5-hydroxytryptophan on the sleep of normal

> human subjects. Electroencephalogr Clin Neurophysiol 30:505-9, 1971

>

> 13. Autret A, et al.: Human sleep and 5-HTP. Effects of repeated high doses

> and of association with benserazide. Electroencephalogr Clin Neurophysiol

> 41:408-13, 1976

>

> 14. Soulairac A and Lambinet H: Clinical studies of the effect of the

> serotonin precursor, L-5-hydroxytryptophan, on sleep disorders. Schweiz

> Rundsch Med Prax 77:19-23, 1988

>

> 15. Titus F, et al.: 5-Hydroxytryptophan versus methysergide in the

> prophylaxis of migraine. Randomized clinical trial. Eur Neurol 25:327-9,

> 1986

>

> 16. Bono G, et al.: Serotonin precursors in migraine prophylaxis. Adv Neurol

> 33:357-63, 1982

>

> 17. Maissen CP and Ludin HP: Comparison of the effect of 5-hydroxytryptophan

> and propranolol in the interval treatment of migraine. Med Wochenschr

> 121:1585-90, 1991

>

> 18. De Giorgis G, et al.: Headache in association with sleep disorders in

> children: a psychodiagnostic evaluation and controlled clinical

> study--L-5-HTP versus placebo. Drugs Exp Clin Res 13:425-33, 1987

>

> 19. Santucci M, et al.: L-5-hydroxytryptophan versus placebo in childhood

> migraine prophylaxis: A double-blind crossover study. Cephalgia 6:155-7,

> 1986

>

> 20. Ribeiro CA. L-5-Hydroxytryptophan in the prophylaxis of chronic

> tension-type headache: a double-blind, randomized, placebo-controlled study.

> For the Portuguese Head Society. Headache 2000;40:451-6.

>

> 21. Nicolodi M and Sicuteri F: Fibromyalgia and migraine, two faces of the

> same mechanism. Serotonin as the common clue for pathogenesis and therapy.

> Adv Exp Med Biol 398:373-9, 1996

>

> 22. Nicolodi M and Sicuteri F: Eosinophilia myalgia syndrome. The role of

> contaminants, the role of serotonergic set up. Exp Biol Med 398:351-7, 1996

>

> 23. Caruso I, et al.: Double-blind study of 5-hydroxytryptophan versus

> placebo in the treatment of primary fibromyalgia syndrome. J Int Med Res

> 18:201-9, 1990

>

> 24. Puttini PS and Caruso I: Primary fibromyalgia syndrome and

> 5-hydroxy-L-tryptophan: a 90-day open study. J Int Med Res 20:182-9, 1992

>

> 25. Klarskov K, et al. Eosinophilia-myalgia syndrome case-associated

> contaminants in commercially available 5-hydroxytryptophan. Adv Exp Med Biol

> 467:461-8, 1999

>

>  

> ------------------------------------------------------------------------

>

> We respect your online privacy. If you prefer not to receive any further

> e-mails from us, please click here. Thank you.

>

>

> © 2005 www.doctormurray.com

>  

>

[Guest guest]

Definitely ask him. My gut tells me it's a bad idea since they both work on

seratonin. You might show him this article and see if you can go off of

your meds for a while and try 5HTP therapy instead.

Kenda

> I wonder about combining this with SSRI antidepressants....

> I am going to ask my doc

>

>

>>

>> Hi,

>>

>> Here is an interesting article on the use of 5HTP for depression, weight

>> loss, headaches and a host of other problems. Dr. Murray was one of Dr.

>> Leu's (my ND) instructors at Bastyr Naturopathic College. Dr. Murray also

>> has a newsletter on his website that you can subscribe to if you are

>> interested. His website is doctormurray.com. There is a lot of really

>> interesting information there!

>>

>> Kenda

>>

>> Answers to Common Questions on 5-Hydroxytryptophan

>>

>> Introduction

>>

>> 5-Hydroxytryptophan (5-HTP) is an amino acid that is the intermediate step

>> between tryptophan and the important brain chemical serotonin. There is a

>> massive amount of evidence that suggests that low serotonin levels are a

>> common consequence of modern living. The lifestyle and dietary practices of

>> many people living in this stress-filled era results in lowered levels of

>> serotonin within the brain. As a result, many people are overweight, crave

>> sugar and other carbohydrates, experience bouts of depression, get frequent

>> headaches, and have vague muscle aches and pain. All of these maladies are

>> correctable by raising brain serotonin levels. The primary therapeutic

>> applications for 5-HTP is for low serotonin states such as:

>>

>> * Depression

>> * Obesity

>> * Carbohydrate craving

>> * Bulimia

>> * Insomnia

>> * Narcolepsy

>> * Sleep apnea

>> * Migraine headaches

>> * Tension headaches

>> * Chronic daily headaches

>> * Premenstrual syndrome

>> * Fibromyalgia

>>

>>

>> Although 5-HTP is relatively new to the United States as a dietary

>> supplement, it has been available in several European countries as a

>> medicine since the 1970s.

>>

>> What advantages does 5-HTP have over L-tryptophan?

>>

>> There are many advantages of 5-HTP over L-tryptophan. First of all, because

>> it is one step closer to serotonin it is more effective. 5-HTP is also

>> inherently safer. Although L-tryptophan is safe if properly prepared and

>> free of the contaminants linked to a severe allergic reaction known as

>> eosinophilia myalgia syndrome (EMS), 5-HTP is a much better choice from a

>> therapeutic and safety perspective. Most commercially available 5-HTP is

>> isolated from a natural source ­ a seed from an African plant (Griffonia

>> simplicifolia).

>>

>> Has 5-HTP been studied in the treatment of depression?

>>

>> There is excellent documentation that 5-HTP is an effective antidepressant

>> agent. 5-HTP often produces very good results in patients who are

>> unresponsive to standard antidepressant drugs. One of the more impressive

>> studies involved 99 patients described as suffering from ³therapy resistant²

>> depression. 1 These patients had not responded to any previous therapy

>> including all available antidepressant drugs as well as electroconvulsive

>> therapy. These therapy resistant patients received 5-HTP at dosages

>> averaging 200 mg daily but ranging from 50 to 600 mg per day. Complete

>> recovery was seen in 43 of the 99 patients and significant improvement was

>> noted in 8 more. Such significant improvement in patients suffering from

>> long-standing, unresponsive depression is quite impressive prompting the

>> author of another study to state ³5-HTP merits a place in the front of the

>> ranks of the antidepressants instead of being used as a last resort. I have

>> never in 20 years used an agent which: (1) was effective so quickly; (2)

>> restored the patients so completely to the persons they had been and their

>> partners had known; [and] (3) was so entirely without side effects.² 2

>>

>> Are there any studies where 5-HTP was compared directly to antidepressant

>> drugs?

>>

>> Yes, there are several. 5-HTP is equal to or better than standard

>> antidepressant drugs and the side effects are much less severe. The study

>> with the most significance was one that compared to fluvoxamine, a

>> ³selective serotonin reuptake inhibitor² like Prozac, Paxil, and Zoloft. In

>> the study, subjects received either 5-HTP (100 mg) or fluvoxamine (50 mg)

>> three times daily for 6 weeks. 3 The percentage decrease in overall

>> depression scores was slightly better in the 5-HTP group (60.7% vs. 56.1%).

>> More patients responded to 5-HTP than fluvoxamine and 5-HTP was quicker

>> acting than the fluvoxamine.

>>

>> The real advantage of 5-HTP in this study was the low rate of side effect.

>> Here is how the physicians described the differences among the two groups:

>>

>> ³Whereas the two treatment groups did not differ significantly in the number

>> of patients sustaining adverse events, the interaction between the degree of

>> severity and the type of medication was highly significant: fluvoxamine

>> predominantly produced moderate to severe, oxitriptan [5-HTP] primarily mild

>> forms of adverse effects.²

>>

>> The most common side effects with 5-HTP were nausea, heartburn, and

>> gastrointestinal problems (flatulence, feelings of fullness, and rumbling

>> sensations). These side effects were rated as being very mild to mild. In

>> contrast, most of the side effects experienced in the fluvoxamine group were

>> of moderate to severe intensity.

>>

>> Using 5-HTP in enteric-coated capsules or tablets (pills prepared in a

>> manner so that they will not dissolve in the stomach) significantly reduces

>> the likelihood of nausea.

>>

>> What effect does 5-HTP have on weight loss?

>>

>> As far back as 1975, researchers demonstrated that administering 5-HTP) to

>> rats that were bred to overeat and be obese resulted in significant

>> reduction in food intake. 4 It turns out that these rats have decreased

>> activity of the enzyme that converts tryptophan to 5-HTP and subsequently to

>> serotonin. In other words, these rats are fat as a result of a genetically

>> determined low level of activity of the enzyme that starts the manufacture

>> of serotonin from tryptophan. As a result, these rats never get the message

>> to stop eating until they have consumed far greater amounts of food than

>> normal rats.

>>

>> There is much circumstantial evidence that many humansare genetically

>> predisposed to obesity. This predisposition may involve the same mechanism

>> as that observed in rats genetically predisposed to obesity. In other words,

>> many people may be predisposed to being overweight because they have a

>> decreased conversion of tryptophan to 5-HTP and, as a result, decreased

>> serotonin levels. By providing preformed 5-HTP, this genetic defect is

>> bypassed and more serotonin is manufactured. 5-HTP literally turns off

>> hunger. 5

>>

>> The early animal studies that used 5-HTP as a weight loss aid have been

>> followed by a series of four human clinical studies of overweight women,

>> conducted at the University of Rome. 6-9 The first study showed that 5-HTP

>> was able to reduce caloric intake and promote weight loss despite the fact

>> that the women made no conscious effort to lose weight. 8 The average amount

>> of weight loss during the five-week period of 5-HTP supplementation was a

>> little more than 3 pounds.

>>

>> The second study sought to determine whether 5-HTP helped overweight

>> individuals adhere to dietary recommendations. 9 The twelve-week study was

>> divided into two six-week periods. For the first six weeks, there were no

>> dietary recommendations; for the second six weeks the women were placed on a

>> 1,200-calorie diet. As shown in Table 1, the women who took the placebo lost

>> 2.28 pounds, while the women who took the 5-HTP lost 10.34 pounds.

>>

>> As in the previous study, 5-HTP appeared to promote weight loss by promoting

>> satiety‹the feeling of satisfaction‹leading to fewer calories being consumed

>> at meals. Every woman who took the 5-HTP reported early satiety.

>>

>> In the third study involving 5-HTP, for the first six weeks there were no

>> dietary restrictions, and for the second six weeks the women were placed on

>> a 1,200-calorie-per-day diet. 10 The results from this study were even more

>> impressive than the previous studies for several reasons. The group that

>> received the 5-HTP had lost an average of 4.39 pounds at six weeks and an

>> average of 11.63 pounds at 12 weeks. In comparison, the placebo group had

>> lost an average of only 0.62 pounds at six weeks and 1.87 pounds at twelve

>> weeks. The lack of weight loss during the second six-week period in the

>> placebo group obviously reflects the fact that the women had difficulty

>> adhering to the diet.

>>

>> Early satiety was reported by 100 percent of the subjects during the first

>> six-week period. During the second six-week period, even with severe caloric

>> restriction, ninety percent of the women taking 5-HTP reported early

>> satiety. Many of the women who received the 5-HTP (300 mg three times per

>> day) reported mild nausea during the first six weeks of therapy. However,

>> the symptom was never severe enough for any of the women to drop out of the

>> study. No other side effects were reported.

>>

>> In the latest study, 25 overweight non-insulin dependent diabetic

>> outpatients were enrolled in a double-blind, placebo-controlled study, and

>> randomized to receive either 5-HTP (750 mg/d) or placebo for two consecutive

>> weeks, during which no dietary restriction was prescribed. 9 Results again

>> indicated that patients receiving 5-HTP significantly decreased their daily

>> energy intake, by reducing carbohydrate and fat intake, and reduced their

>> body weight.

>>

>> While these studies used relatively high dosages, my feeling is that lower

>> dosages (e.g., 100 mg twenty minutes before meals) are just as effective

>> (especially from a cost perspective).

>>

>> How does 5-HTP compare with melatonin in the treatment of insomnia?

>>

>> 5-HTP may prove to be better than melatonin. Several clinical studies have

>> shown 5-HTP to produce good results in promoting and maintaining sleep in

>> normal subjects as well as those experiencing insomnia. 10-13One of the key

>> benefits with 5-HTP in the treatment of insomnia, is its ability to increase

>> sleep quality.

>>

>> How does 5-HTP benefit headache sufferers?

>>

>> Because chronic headache sufferers have low levels of serotonin in their

>> tissues, some researchers refer to migraine and chronic headaches as a ³low

>> serotonin syndrome.² 14 There have been several clinical studies with 5-HTP

>> in headaches, both migraine and tension headaches, that have showed

>> excellent results. 14-20 In particular, the use of 5-HTP in the prevention

>> of migraine headache offers considerable advantages over drug therapy.

>> Although a number of drugs have been shown to be useful in the prevention of

>> migraine headaches, all of them carry significant side effects. In contrast,

>> 5-HTP is very safe.

>>

>> What is fibromyalgia and how does 5-HTP help?

>>

>> Fibromyalgia is a recently recognized disorder regarded as a common cause of

>> chronic musculoskeletal pain and fatigue. The history of the development of

>> 5-HTP as an effective treatment for fibromyalgia began with studies on the

>> drug fenclonine. 21 This drug blocks the enzyme which converts tryptophan to

>> 5-HTP and as result blocks serotonin production. During the late 1960s and

>> early 1970s, it was thought that increased serotonin formation may promote

>> migraine headaches (the opposite of what was later proved, i.e., increasing

>> serotonin levels reduce migraine headache occurrence). The researchers

>> discovered that providing headache sufferers with fenclonine resulted in

>> very severe muscle pain. This effect was exactly opposite of what was

>> expected, but led to some important advances in the understanding of

>> fibromyalgia--a way to induce its severe symptoms of (as well as symptoms

>> nearly identical to EMS, the condition caused by contaminated L-tryptophan).

>> The researchers also discovered that migraine sufferers reacted to the drug

>> much more than non-headache sufferers. In fact, in most normal subjects

>> fenclonine produced no fibromyalgia. These occurrences highlight just how

>> sensitive migraine sufferers are to low serotonin levels.

>>

>> Migraine headaches and fibromyalgia share a common feature: both are low

>> serotonin syndromes. After over 25 years of research, one of the lead

>> researchers has stated that ³In our experience, as well as in that of other

>> pain specialists, 5-HTP can largely improve the painful picture of primary

>> fibromyalgia.² 22 Double-blind studies support this contention. 23,24

>>

>> What is the best way to take 5-HTP?

>>

>> For depression, weight loss, headaches, and fibromyalgia the dosage should

>> be started at 50 mg three times per day. If the response is inadequate after

>> two weeks, increase the dosage to 100 mg three times per day. This

>> recommendation will greatly reduce the mild symptoms of nausea often

>> experienced during the first few weeks of 5-HTP therapy. Using

>> enteric-coated capsules or tablets (pills prepared in a manner so that they

>> will not dissolve in the stomach) significantly reduces the likelihood of

>> nausea. Because 5-HTP does not rely on the same transport vehicle as

>> L-tryptophan, it can also be taken with food. But, if you are taking for

>> weight loss I recommend taking it 20 minutes before meals.

>>

>> For insomnia, I recommend 100 to 300 mg thirty to forty-five minutes before

>> retiring. Start with the lower dose for at least three days before

>> increasing dosage.

>>

>> Can 5-HTP be taken with St. ¹s wort extract?

>>

>> Yes. In fact, the two seem to work very well together. St. ¹s wort

>> extract has been shown in over 25 double-blind studies to be as or more

>> effective than antidepressant drugs in the treatment of mild to moderate

>> depression. In more severe cases, I recommend using 5-HTP along with St.

>> ¹s wort. Be sure to use the St. ¹s wort extract standardized for

>> 0.3% hypericin. The dosage for this extract is typically 300 mg three times

>> per day. When using it in combination with 5-HTP I recommend 50-100 mg of

>> 5-HTP and 150-300 mg of St. ¹s wort extract three times daily.

>>

>> What about using 5-HTP with antidepressant drugs?

>>

>> Although 5-HTP has been shown to work very well with antidepressant drugs in

>> clinical trials, my recommendation is that if you are taking a prescription

>> antidepressant drug, DO NOT take 5-HTP until you consult with your doctor.

>> It is possible for serotonin levels to get too high. The result is a

>> condition known as the ³serotonin syndrome,² which is characterized by

>> confusion, fever, shivering, sweating, diarrhea, and muscle spasms.

>>

>> That being said, with your doctor¹s supervision, 5-HTP can be used in

>> conjunction with antidepressant drugs. The typical dosage schedule is to

>> begin with a dosage of 5-HTP at 50 mg three times daily; after one month,

>> the dosage of the antidepressant drug can be cut in half. If satisfactory

>> response is achieved after the next month, increase the dosage of 5-HTP to

>> 100 mg three times daily and discontinue the medication. Again, your

>> physician must supervise any change in the dosage of your medication.

>>

>> Wasn¹t the drug Redux, which raises serotonin levels, taken off the market

>> because it caused damage to the heart valves due to elevated blood serotonin

>> levels? Is there a risk with 5-HTP doing the same?

>>

>> In September 1997, the popular weight loss drug Redux and its chemical

>> cousin fenfluramine, part of the ³fen-phen² combination, were taken off the

>> market based on a study showing that these drugs may have caused permanent

>> damage to heart valves in as many as one-third of the people who took them.

>> There is no evidence that 5-HTP produces these effects. Unlike Redux, 5-HTP

>> does not raise blood serotonin levels to a significant degree nor does it

>> block reuptake of serotonin. The point here is that 5-HTP does not disrupt

>> the normal process of serotonin release, reabsorbtion, and elimination from

>> the body. 5-HTP is not a synthetic drug; it is an amino acid produced

>> naturally by your body¹s metabolism.

>>

>> What is ³peak X?²

>>

>> In 1998 researchers at the Mayo Clinic identified trace levels of a compound

>> they termed ³peak X² as a possible contaminant in 5-HTP products. 25 Though

>> the significance of this compound was never really established,

>> manufacturers of 5-HTP now screen for the presence of this compound to

>> insure that all of the 5-HTP on the marketplace is free from peak X as

>> outlined in current FDA methodology. There have been no reports of a single

>> person developing eosinophilia-myalgia syndrome (EMS) from 5-HTP despite its

>> popularity. Evidence that uncontaminated 5-HTP does not cause EMS is also

>> provided by researchers who have been using 5-HTP for over 30 years as well

>> as by researchers at the NIH studying the effects of uncontaminated 5-HTP on

>> various metabolic conditions.

>>

>> Is 5-HTP safe for long term use?

>>

>> Yes, but to be on the safe side I recommend that long-term continual use of

>> 5-HTP be monitored by regular (every six months) eosinophil determination.

>> This determination is part of a standard laboratory blood test known as a

>> complete blood count (CBC).

>>

>> * Do not use 5-HTP during pregnancy or lactation.

>> * Do not use 5-HTP in Parkinson¹s disease unless the drug Sinemet®.

>> * Do not use 5-HTP if you have sceleroderma (linked to a defect in

>> tryptophan metabolism).

>>

>>

>> Are there any drug interactions?

>>

>> Again, because 5-HTP is the direct precursor to serotonin, it should not be

>> used by individuals taking antidepressant drugs without close medical

>> supervision. 5-HTP may antagonize the effects of drugs used in migraine

>> headaches like methysergide and cyproheptadine.

>>

>> What about carbidopa and vitamin B6?

>>

>> The drug carbidopa blocks the conversion of 5-HTP to serotonin from

>> occurring outside the brain. This effect initially was thought to be

>> desirable and the combination of 5-HTP and carbidopa was used in several

>> studies. However, studies using 5-HTP alone (i.e., without carbidopa) were

>> shown to produce even better results, especially in relieving depression.

>>

>> Vitamin B6 is required for the conversion of 5-HTP to serotonin. Some

>> ³experts² advise against taking 5-HTP at the same time with vitamin B6 while

>> others recommend taking the two simultaneously. The bottom line is that

>> there is no evidence that taking vitamin B6 with 5-HTP increases the

>> conversion of 5-HTP to serotonin in the blood (an undesirable effect) while

>> there is evidence that lack of vitamin B6 will definitely reduce brain

>> serotonin manufacture. My recommendation is that adequate B6 stores are

>> achieved by taking a high potency multiple vitamin and mineral formula.

>>

>> Why does 5-HTP supplementation produce nausea?

>>

>> Again, while nausea is a common side effect of 5-HTP, it can be avoided by

>> simply taking an enteric-coated product. 5-HTP induces nausea via a local

>> effect on the stomach lining.

>>

>> Where can I get more information on 5-HTP?

>>

>> The overwhelming majority of questions sent to me via my website are related

>> to 5-HTP. I have tried to answer all of the most common questions here. For

>> more information, see my book, 5-HTP ­ The Natural Way to Overcome

>> Depression, Obesity, and Insomnia (Bantam, 1998). It provides more detailed

>> information on 5-HTP and is available in book stores and health food stores

>> nationwide.

>>

>> References

>>

>> 1. van Hiele JJ: L-5-hydroxytryptophan in depression: The first substitution

>> therapy in psychiatry? Neuropsychobiology 6:230-40, 1980

>>

>> 2. Kielholz P: Treatment for therapy-resistant depression. Psychopathology

>> 19(Suppl. 2):194-200, 1986

>>

>> 3. Poldinger W, Calanchini B and Schwarz W: A functional-dimensional

>> approach to depression: Serotonin deficiency as a target syndrome in a

>> comparison of 5-hydroxytryptophan and fluvoxamine. Psychopathology 24:53-81,

>> 1991

>>

>> 4. Wurtman RJ and Wurtman JJ: Brain serotonin, carbohydrate-craving, obesity

>> and depression. Adv Exp Med Biol 398:35-41, 1996

>>

>> 5. Blundel JE and Leshem MB: The effect of 5-HTP on food intake and on the

>> anorexic action of amphetamine and fenfluramine. J Pharm Pharmacol 27:31-7,

>> 1975

>>

>> 6. Ceci F, et al.: The effects of oral 5-hydroxytryptophan administration on

>> feeding behavior in obese adult female subjects. J Neural Transm 76:109-17,

>> 1989

>>

>> 7. Cangiano C, et al.: Effects of 5-hydroxytryptophan on eating behavior and

>> adherence to dietary prescriptions in obese adult subjects. Adv Exp Med Biol

>> 294:591-3, 1991

>>

>> 8. Cangiano C, et al.: Eating behavior and adherence to dietary

>> prescriptions in obese adult subjects treated with 5-hydroxytryptophan. Am J

>> Clin Nutr 56:863-7, 1992

>>

>> 9. Cangiano C, Laviano A, Del Ben M, et al. Effects of oral

>> 5-hydroxy-tryptophan on energy intake and macronutrient selection in

>> non-insulin dependent diabetic patients. Int J Obes Relat Metab Disord

>> 22(7):648-54, 1998.

>>

>> 10. Wyatt RJ: The serotonin-catecholamine-dream bicycle: a clinical study.

>> Biol Psychiatry 5:33-64, 1972

>>

>> 11. Guilleminault C, Cathala HP and Castaigne P: Effects of 5-HTP on sleep

>> of a patient with brain stem lesion. Electroencephalog Clin Neurophysiol

>> 34:177-84, 1973

>>

>> 12. Wyatt RJ, et al.: Effects of 5-hydroxytryptophan on the sleep of normal

>> human subjects. Electroencephalogr Clin Neurophysiol 30:505-9, 1971

>>

>> 13. Autret A, et al.: Human sleep and 5-HTP. Effects of repeated high doses

>> and of association with benserazide. Electroencephalogr Clin Neurophysiol

>> 41:408-13, 1976

>>

>> 14. Soulairac A and Lambinet H: Clinical studies of the effect of the

>> serotonin precursor, L-5-hydroxytryptophan, on sleep disorders. Schweiz

>> Rundsch Med Prax 77:19-23, 1988

>>

>> 15. Titus F, et al.: 5-Hydroxytryptophan versus methysergide in the

>> prophylaxis of migraine. Randomized clinical trial. Eur Neurol 25:327-9,

>> 1986

>>

>> 16. Bono G, et al.: Serotonin precursors in migraine prophylaxis. Adv Neurol

>> 33:357-63, 1982

>>

>> 17. Maissen CP and Ludin HP: Comparison of the effect of 5-hydroxytryptophan

>> and propranolol in the interval treatment of migraine. Med Wochenschr

>> 121:1585-90, 1991

>>

>> 18. De Giorgis G, et al.: Headache in association with sleep disorders in

>> children: a psychodiagnostic evaluation and controlled clinical

>> study--L-5-HTP versus placebo. Drugs Exp Clin Res 13:425-33, 1987

>>

>> 19. Santucci M, et al.: L-5-hydroxytryptophan versus placebo in childhood

>> migraine prophylaxis: A double-blind crossover study. Cephalgia 6:155-7,

>> 1986

>>

>> 20. Ribeiro CA. L-5-Hydroxytryptophan in the prophylaxis of chronic

>> tension-type headache: a double-blind, randomized, placebo-controlled study.

>> For the Portuguese Head Society. Headache 2000;40:451-6.

>>

>> 21. Nicolodi M and Sicuteri F: Fibromyalgia and migraine, two faces of the

>> same mechanism. Serotonin as the common clue for pathogenesis and therapy.

>> Adv Exp Med Biol 398:373-9, 1996

>>

>> 22. Nicolodi M and Sicuteri F: Eosinophilia myalgia syndrome. The role of

>> contaminants, the role of serotonergic set up. Exp Biol Med 398:351-7, 1996

>>

>> 23. Caruso I, et al.: Double-blind study of 5-hydroxytryptophan versus

>> placebo in the treatment of primary fibromyalgia syndrome. J Int Med Res

>> 18:201-9, 1990

>>

>> 24. Puttini PS and Caruso I: Primary fibromyalgia syndrome and

>> 5-hydroxy-L-tryptophan: a 90-day open study. J Int Med Res 20:182-9, 1992

>>

>> 25. Klarskov K, et al. Eosinophilia-myalgia syndrome case-associated

>> contaminants in commercially available 5-hydroxytryptophan. Adv Exp Med Biol

>> 467:461-8, 1999

>>

>>  

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[Guest guest]

You are correct: You can't take any supps. that affect serotonin while

on SSRI antidepressants.